Acinetobacter baumannii infection in solid organ transplant recipients

Abstract

SOT recipients with A. baumannii infection had high mortality associated with delay in appropriate antibiotic therapy and XDR organisms. The use of colistin-containing treatment regimens should be considered in these patients when A. baumannii infection is suspected or identified in patients who have received prior antibiotics.

Toll-Like Receptor 9 Contributes to Defense against Acinetobacter baumannii Infection

“…Understanding how the healthy host successfully senses and defends against such pathogens may provide insights leading to muchneeded therapeutic approaches centered on recapitulating an effective immune response. A. baumannii is one such pathogen that causes severe diseases associated with high mortality in at-risk patients (1)(2)(3)(4)(5). In addition, A. baumannii has developed resistance to every antibiotic available to treat these infections (6)(7)(8).…”

“…A. baumannii is among the most frequent causes of nosocomial infections in critically ill patients worldwide, where it is capable of causing pneumonia, urinary tract, and bloodstream infections and is also a frequent cause of burn wound infections (1)(2)(3). Patients with immunosuppression related to solid organ and hematologic transplantation are at increased risk for A. baumannii disease, and these infections are associated with high mortality (4,5). The public health threat of A. baumannii is amplified by the organism's remarkable ability to acquire resistance to antimicrobial agents.…”

Antibiotic-Resistant Infections and Treatment Challenges in the Immunocompromised Host

“…Two studies looked at the number of A baumannii isolates that were extensively drug resistant (XDR). 18,19 XDR status was common in these 2 studies, with Kim and colleagues reporting rates of 75.7% and Kitazano and colleagues reporting 21.2%. In addition to these studies on XDR A baumannii, several other studies investigated carbapenem resistance in A baumannii and found it was quite common.…”

“…Risk factors that were found to be significant in more than 1 study included prior transplant, 7,16 length of stay before infection, 20,31 advancing age, 16,20 hemodialysis, 15,21 and prior antibiotic. 7,15,19,31 As far as antecedent antibiotics are concerned, XDR A baumannii and carbapenem-resistant A baumannii were found to be associated with prior carbapenem use. 15,19 Greater acuity of illness was found to be associated with resistant pathogens in several studies with septic shock, 7 admission to the intensive care unit, 31 and respiratory failure 31 being associated in 3 separate studies.…”

“…7,15,19,31 As far as antecedent antibiotics are concerned, XDR A baumannii and carbapenem-resistant A baumannii were found to be associated with prior carbapenem use. 15,19 Greater acuity of illness was found to be associated with resistant pathogens in several studies with septic shock, 7 admission to the intensive care unit, 31 and respiratory failure 31 being associated in 3 separate studies.…”